USA Today op-ed: Medicare’s never events and the unintended consequences affecting patient care

My latest USA Today op-ed was published this morning: Medicare’s mistake

I discuss Medicare’s recent “never event” initiative, the program where hospitals are denied payment for catastrophic medical errors.

However, the rapid expansion into not paying for “reasonably preventable” events, like hospital acquired infections and patient falls, can paradoxically have a detrimental effect on patient care.


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  • Anonymous

    This commentary is silly, but you can be forgiven. CMS is using some unfortunate language. But it’s just a word: “never.” Get past it.

    No rational person expects that “never” events will never happen. Neither does CMS. But these are events that we all agree should be reduced in frequency. Therefore the CMS payment incentive goes in the right direction.

    Until you show hard evidence of an “unintended consequence” that _outweighs_ a beneficial intended effect, this is silly speculation.

  • Edwin

    Having experienced the aftermath of government responses to adverse incidents, having experienced malpractice and JCAHO visits and all the rest, I feel confident that when a government, running out of money, says ‘never,’ they mean ‘never.’ It’s really less a way to protect patient safety and far more a way to divert money. It’s ingenious, really, in the same way as Medicare’s billing codes are brilliant devices for payment denial.

    Here are some ‘never’ events we need: there will never be a White House Scandal…never be money changing hands under the table in Congress…never be lies told by government officials under oath…never be policies based on bad science or bad intelligence.

    We’ll ‘never’ see that kind of accountability in Washington.


  • Anonymous



    PS: All physicians need to immediately drop out of Medicare, Medicaid, and any other government program to stop this nonsense.

  • Dr J

    The CMS “never event” list includes catheter-associated urinary tract infections, catheter-associated vascular infections, mediastinitis after CABG, and surgical site infections. It is doubtful that patients brought these into the hospital.

  • Michael Kirsch, M.D.

    The ‘never events’ strategy, which I oppose, should never have been implemented. It has a populist appeal now,protecting patients against having the wrong limb removed. In time, however, the list of events will mestastasize and will include many events and outcomes that cannot be prevented. Right now, only hospitals are punished, even if the physician is the offender. Soon, all physicians and medical venues will be targeted. Will it help actual patients? I doubt it. The never events cheerleaders, like other medical quality proponents, think they can define and measure medical performance. They can’t.

  • Michael Kirsch, M.D.

    Regarding Dr. J’s comments, I accept that patients with catheter induces UTI or post-op mediastinitis developed these events in the hospital. These are complications, not ‘never events’. A post-operative infection cannot have a ‘never event’ designation like removing the wrong kidney. Why not just declare every unfortunate outcome or complication to be a ‘never event’? That’s where the path is leading. Let’s change direction.

  • Nancy Leigh Noffsinger

    Why would surgeries be performed without knowledge of
    patient. Back surgery performed in secret, and then patient moves furniture unknowingly. Most people, including me, are not that savvy about electronic medicine. That is why the delerium sets in. If I hadn’t had this one friend to rely on, I would be in a padded cell today instead of on a computer. Last night I heard a good friend had survived ovarian cancer for 25 years, and now had lung cancer. That is strange since he has not had a cigaretter in 20 years. Lots of second hand smoke, however. Why would all that be kept from him???? Most Sincerely, Glenda

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